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A Canadian doctor diagnoses U.S. healthcare

CANADIAN DOCTORS DEMAND MORE PAY

On costs, Canada spends 10% of its economy on healthcare; the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don’t need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can’t charge as much when they have to deal with a single payer. Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative costs and can negotiate lower prices. Because most of the difference in spending is for non-patient care, Canadians actually get more of most services. We see the doctor more often and take more drugs. We even have more lung transplant surgery.

has really contracted a lot with some of the practices the HMOs have adopted recently, so there just arent the opportunities there, Mr. Grant said. When the Canadian dollar was 65 cents, U.S. salaries looked terrific. When its near par, its not so good we now have been seeing a reverse flow, there are more physicians coming to Canada than leaving Canada. That shift may give provincial governments the political leverage to bring doctor remuneration in line with increasingly tight budgets. A report also released on Tuesday from the conservative Fraser Institute suggests healthcare costs in Canada are growing at faster rate than shelter, food and the average income. A family of two parents and two children with an average income of more than $113,000 can expect to pay more than $11,000 in taxes to the countrys publicly funded system. The fact is, Canadian families pay thousands of dollars in taxes every year to cover the cost of public health care insurance. And that cost rose 1.5 times faster than average income over the past decade, said Nadeem Esmail, Fraser Institute director of health policy studies. Physician pay is a tricky matter that is difficult to compare directly: doctors are essentially contract employees for their respective provinces. Each province negotiates a fee per service provided. Doctors then have to pay for their own overhead, including rent and administrative help. A report for the Canadian Institute for Health Research found that doctors made, on average, $307,482 in 2010-11. Physicians in Alberta were paid the most. Ontario doctors came in second, while those in the Atlantic provinces and Quebec earned the least. However, those figures didnt take doctors costs into consideration.

Doctor salaries have shot up 30% in past decade over fears of physician shortage, brain drain to U.S.: report

In Ontario, Canada’s largest province, 15,000 doctors have been staying away from their offices or refusing to perform some services, such as prescribing drugs by telephone. Some 5,500 general practitioners in Quebec, the second largest province, are threatening to close their offices for a day next week. At issue in both cases is the official schedule for fees that doctors are supposed to charge for medical services; talks between the provincial governments and the medical associations on new schedules have produced no agreement. There is a similar clash in Manitoba, and over the last four years doctors have shown discontent at times in almost every province. Officials speak of the Canadian health system as ”one of the best in the world,” but the Canadian Medical Association says the system is underfinanced. Doug Geekie, spokesman for the association, said Canada was devoting to health care 7.2 percent of its gross national product, the sum of all goods and services produced. He said that among Western nations only Britain spent less than this and that the United States devoted about 10 percent of its G.N.P. to health care. Ottawa Cuts Contributions With inflation running high and the federal Government anxious to keep its deficit down, the 10 provinces, which are responsible for their own health systems, are undergoing a particularly tight financial squeeze this year. Ottawa has cut the rate of growth of its contributions to the provinces for health care by about 15 percent. Well before the cuts, doctors’ incomes were losing ground to those of other professional groups, the Medical Association says. It cited tax figures indicating that between 1971 and 1977 lawyers, dentists and accountants increased their incomes at a much faster rate than doctors.